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Clinical Medicine > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

reasons why elderly pop going up

A

baby boomers
up like expectancy
up immigration
down fertility rate

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2
Q

avg life expect

A

84

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3
Q

marriage/living situation

A

42% women widowed

72% of men live with spouse (50% women)

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4
Q

chronic conditions (%s)

A

80% have 1

50% have 2

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5
Q

chronic conditions (health care costs)

A

75% of costs

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6
Q

MC conditions > 65

A

HTN

arthritis

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7
Q

MC deficit

A

walking

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8
Q

what ups likelihood of living in LT care

A

3+ ADL limitations

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9
Q

MCC death

A

heart dz
cancer
stroke

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10
Q

CPG means…

A

clinical practice guidelines

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11
Q

age – fat changes

A

up fat up distribution of lipophilic drugs (anti-psych, TCAs)
up rx 1/2 life

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12
Q

age – muscle changes

A

less muscle mass – rx that bind to muscle need to be lower (digoxin)

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13
Q

age – protein

A

protein binding doesnt change w/ age

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14
Q

age – HR

A

resting HR doesnt change
max HR goes down
208 - age(0.7)

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15
Q

age - vessels

A

up tunica media thickness
down elastin
(up stiff/BP)
predispose to athero

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16
Q

age – BP

A

up SBP more than DBP

up ortho HTN (dizzy not normal tho!)

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17
Q

CV changes: stay same

A

HR

SV

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18
Q

CV changes: up

A

tunica media thickness

vasc afterload

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19
Q

CV changes: down

A

CO
contractility
beta rec responsiveness
elastin

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20
Q

pseudodementia features

A

affects recall
inconsistent deficits
elicits “i don’t know” more often than incorrect answers
less language/global impairments

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21
Q

SIGECAPS

A

depression +

sleep, interests, guilt, energy, concentration, appetite, psychomotor retardation, suicide

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22
Q

first line for depression

A

SSRI or SNRI

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23
Q

first line for anxiety

A

SSRI

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24
Q

MC anxiety

25
gold standard tx for depression
ECT
26
prevalence of depression in long term care
15% (1% in gen pop)
27
1st sign of atrophy in AD (location)
entorhinal cortex
28
tx of choice for vascular dementia
lower BP
29
FTD subtype
picks
30
lang fxn in HIV assoc dementia
usually intact
31
visual disturbances in dementia
LBD > AD
32
35-70 dementia
FTD
33
better @ recalling words w/ hints?
vascular > AD
34
NPH triad
wacky wobbly wet
35
family Hx dementia
AD, FTD, lewy is sporadic
36
executive fxn deficits
parkinsons, AD late, LBD late, FTD early
37
dementia >. 65
LBD, AD (not FTD)
38
AD atrophy
diffuse
39
LBD features
fluctuations in cognitive fxn persistent hallucinations spontaneous parkinsons motor features
40
dementia w/ less Ach than AD
lewy body
41
LBD atrophy
diffuse
42
amyloid plaques w/o NFTs
LBD
43
hyperorality dementia
FTD
44
delirium features/Sx
``` acute onset * fluctuating levels of consciousness* picking at clothing* inattention (do digit span test) memory loss disorientation apathy agitation delusions disturbed sleep ```
45
dementia features/Sx
``` memory impairment* day/night reversal* hoarding* disorientation agitation disturbed sleep ```
46
depression features/Sx
``` sadness* loss of interest* I don't know answers are common* disturbed sleep trouble concentrating down energy worthlessness suicide things ```
47
GDS #s
>5 may be depressed (+ask about suicidality) | > 10 for sure
48
adipose changes with age
more adipose
49
glut-4 changes w/ age
less glut-4
50
statin w/ lowest risk of myopathy
pravastatin
51
meds that raise BP
``` steroids sympathomimetics decongestants NSAIDs cyclosporine tacrolimus EPO ```
52
DM blood sugar levels
fasting >126, random >200
53
DM goals
HbA1C
54
% of elderly with DM
20%
55
how to dx ortho hTN
take lying down stand, take after 1/3/5 min > 20 fall in systolic >10 fall in diastolic
56
HbA1C >11% needs intervention by when
3 mo
57
atypical depression sx
j
58
P for irreversible tissue damage
> 70 for 2 hrs
59
dementia with progressive gait d/o
vascular | hydrocephalus

Clinical Medicine (9 decks)

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